Transfusion medicine handbook

5. Fractionated Products

5.4.7 BERIRAB P (Rabies Immunoglobulin)

This product does not have full New Zealand registration and so consultation with an NZBS Transfusion Medicine Specialist/Medical Officer is required prior to product release. It is supplied by NZBS under Section 29, a provision in the Medicines Act 1981, whereby a medical practitioner can prescribe a medicine that is not registered with Medsafe.

Berirab P is a sterile solution of anti-rabies immunoglobulin prepared from the plasma of individuals immunised with rabies vaccine. Donations are selected on the basis that they contain high levels of rabies antibody. Each 1 mL of Berirab P contains a minimum of 150 IU/mL of rabies antibody. Berirab P should be administered intramuscularly. If anatomically feasible, the full dose should be thoroughly infiltrated in the area around and into the wounds. Any remaining volume should be injected intramuscularly at a site distant from vaccine administration.

Indications for Use

Berirab P is indicated for prophylaxis in individuals suspected of having exposure to rabies from:

• Bites, licks, scratches or other injuries caused by a suspected rabid animal
• Mucous membrane contamination with infectious tissue or saliva of suspected rabid animal
• Mucous membrane or new skin wound contact with rabies live attenuated vaccine (e.g., vaccination baits)

The exception to these indications is individuals who have previously been immunised, pre- or post-exposure, with rabies vaccine prepared from human diploid cells.

The recommended dose of Berirab P is 20 IU per kg body weight which should be given in conjunction with rabies vaccine.